The Association between POTADS community support and activities of daily living independence among adolescents with Down syndrome in urban Indonesia: A cross-sectional study

Abstract

Introduction: Functional independence is a key developmental milestone for adolescents with Down syndrome (DS), yet evidence from low- and middle-income countries examining community-based influences on daily living abilities remains scarce. POTADS, a parent-led organization in Indonesia, provides emotional, informational, and instrumental support, but its direct impact on adolescents' functional independence has not been empirically evaluated.
Objectives: To analyze the association between POTADS community support and independence in activities of daily living (ADL) among adolescents with DS in an urban Indonesian setting.
Methods: A cross-sectional study was conducted among 53 adolescents aged 11–18 years who were active members of POTADS. Community support was measured using a modified social support scale, and ADL independence was assessed using the adapted self-care domain of the Pediatric Evaluation of Disability Inventory. Data were analyzed using Spearman's rho due to non-normal distribution.
Results: Nearly all parents reported high levels of community support (98%), whereas most adolescents reported high levels of ADL independence (89%). A statistical analysis revealed no significant association between community support and ADL independence (rₛ = –0.156; p = 0.264). Minimal variability in responses and ceiling effects may explain the lack of correlation.
Conclusions: POTADS community support was not directly associated with ADL independence in this study. Nonetheless, the community may provide indirect benefits, such as empowerment for parents. Including skill-focused, family-based training in nursing and community initiatives could potentially improve adolescents' functional independence.